外傷後慢性疼痛症候群の心身医学的検討

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Fourteen patients suffering from chronic post-traumatic pain were examined and treated from both physical and mental viewpoints. The subjects consisted of 3 men and 11 women with the mean age of 44 years. The mean period from injury until initial examination at this department was 19 months. Neurologically, cranial nerve palsy was noted in 2 patients, whereas the other patients suffered from subjective symptoms without any distinct signs of abnormalities, including the results of auxiliary examinations. Psychological examinations indicated that the behavioral profiles of these patients were characterized by being neurotic with a high degree of anxiety and depression, strong tension in interpersonal relations, and a lack of rational judgment. In 11 patients behavioral therapy and other modes of psychosomatic treatment were carried out in conjunction with physical therapy. This treatment regimen was therapeutically effective in alleviating pain or promoting awareness of psychological factors in 8 of these patients. Although the distinction between chronic pain and psychogenic pain is difficult, we concluded, based on the review of various literature, that : (1) chronic post-traumatic pain should be treated as a psychosomatic disease regardless of the nature of neurotic and depressive factors, and (2) chronic pain is one type of syndrome generated by the complex interplay of the biological response and psychogenic response of the patient.
日本心身医学会の論文
1993-12-01

外傷後慢性疼痛症候群の心身医学的検討

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